Provider Demographics
NPI:1083068167
Name:HUGHES, ANALISE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANALISE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 BELLAMY AVE UNIT 691
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-3627
Mailing Address - Country:US
Mailing Address - Phone:843-651-4600
Mailing Address - Fax:843-651-4601
Practice Address - Street 1:4017 HIGHWAY 17 # 200
Practice Address - Street 2:
Practice Address - City:MURRELLS INLT
Practice Address - State:SC
Practice Address - Zip Code:29576-5032
Practice Address - Country:US
Practice Address - Phone:843-651-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005308363AM0700X
SC2979363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical